PARACETAMOL POISONING IN THE NORTH-EAST OF ENGLAND - PRESENTATION, EARLY MANAGEMENT AND OUTCOME

1 Paracetamol is increasingly involved in self-poisoning in the United Kingdom and remains a common cause of fatal poisoning. 2 To document the epidemiology and early management of paracetamol poisoning data we re collected on consecutive patients with suspected paracetamol poison ing presenting to 6 hospitals in the North East of England over 12 wee ks in 1994. 3 There were 400 presentations (attendance rate 1.14/10(3) population/yr) involving 343 persons (45% male). Paracetamol concentr ations at 4 h correlated weakly with reported paracetamol dose (R=0.49 , P<0.0001) and were similar comparing those treated and not treated b y gastric decontamination. 4 In 38 (9%) cases paracetamol concentratio ns were above the appropriate nomogram treatment line, including 3% an d 20% of patients who reported ingesting less than and more than 12 g respectively. In 21 patients acetylcysteine treatment was deferred unt il admission to the ward, the mean delay involved was 2.8 h. 5 One pat ient died, from arrhythmias caused by co-ingested dothiepin. 6 Paracet amol poisoning is common. Most cases do not have potentially toxic pla sma paracetamol concentrations, but those who do often present late an d antidotal treatment may be delayed inappropriately.